Choices and Chances
by Merida Hughsie
Summary: They both feel like they have nothing left to live for, but oh were they wrong. New chances arise in their lives and choices will have to be made.
1. Chapter 1: New Doctor

Choices and chances

Chapter 1: New doctor

Keith Zetterstrom was an extraordinary boy. In what way you might ask and I would smile and say "In every way".

As a paediatric cardiologist I had come across many children in various states. Many tried to believe their parents and doctors when they were told that everything would be alright and they would be fine in no time. Some were crying constantly from pain and fear and some others were simply giving up, staring ahead of them, not responding to anyone. They all had in common, though, that they depended on me and that I felt deeply for each and every one of them. I tried desperately to help them all. Sometimes I lost the battle for life and a small flame died. People say that a mother should never see her child die because part of her dies. I am no mother but I with every new child I can't help but let it into my heart … this child becomes part of me. And I suffer when I can't heal his or her heart. I die a little bit every time I lose a patient.

So why do this? Simple. Because my losses are few and most of my students survive – thanks to me. If it hadn't been for me standing over them and operating on them or giving them a heart massage right after they were born to start their hearts, they wouldn't exist. I am a mother – a mother of many. My children send me cards to all the holidays, they invite me to their homes, they stay in contact with me their entire lives.

And then there are the cases that are even more special. Every now and then you get a real fighter who won't, under no circumstances, give up and quit fighting. Keith was one of those. He had cancer, like my deceased husband, and at that time the cancer had corrupted his heart. So he was transferred to my ward and put in my care.

I remember so clearly the first time we met.

_Keith was not exactly sure what to think. Neither his father nor Al would really talk to him and tell him what was wrong with him now. All Keith knew was that he had trouble doing stuff that hadn't given him trouble a few weeks ago. Everything seemed more strenuous than before and he often had to gasp for breath. With an inward sigh Keith shrugged his shoulders and decided it didn't matter. Life was too short to worry too much, especially in his case._

_His first proof that something was more wrong than just a check-up could be, came when he entered the war. The sign on the door read 'Cardiology' and as far as his Latin went that meant 'Heart'. He had thought that his cancer wouldn't affect his heart …_

_A frown creased his forehead now. He was about to demand a straight answer from his father when he heard a musical voice behind him. _

_ "Mr. Zetterstorm, I presume," the voice said gently, holding something Keith hadn't heard in a long while._

_Nevertheless he was just about to whip around and snap at the doctor that he was the main character here when he came face to face with the owner of that gentle voice. He met the bluest set of eyes he had ever seen. Before he could even formulate something – anything – to say to that woman, she reached up and gently stroked away the frown on his forehead. _

_ "You are Mr. Zetterstrom, right?" she asked gently. Her eyes dancing with silent laughter. _

_Keith was thrown by this woman. The doctors had always treated him like a child, only telling his father the important stuff and patronizing Keith. Their eyes had always been sad as if to say 'Poor boy, you will never truly live'. Keith was sick and tired of that treatment. Now this new doctor addressed him and ignored his father. He nodded curtly, not finding his voice, which was unlike him._

_ "Well, then, Mr. Zetterstrom, I am Catherine Howard, your cardiologist. I am also the chief doctor of this ward and in this instance I have to tell you …" Her voice took on a distinctly stricter tone and Keith felt it coming, the 'You're as good as dead'-speech, mixed in with a heavy dose of 'You better do as you're told and stay in bed feeling sorry for yourself'. "… there is no frowning on my ward." Keith actually took a step back, but Dr. Howard didn't appear to notice. "Many of the children on this ward live their lives overshadowed by heart-conditions so they really don't need to be reminded about it every step they take and it most certainly doesn't help them to see nothing but sad and depressed faces. We believe in making them feel comfortable and happy here, hopefully succeeding in letting them forget their conditions for a while. There is a clown for the younger children who comes in every afternoon." Here she leaned towards him conspiratorially. "It's really one of the local elementary school teachers, but don't tell them. And there is a room for the older chil… erm, I mean young adults with TVs and game consoles and a kicker and lots of other stuff." She smiled at him and Keith felt instantly that he could trust her, that she would stop at nothing to make him feel better. "So any questions?"_

_ "Huh … oh … yeah, well … when's my first appointment, Dr Howard?" he asked dumbly and hated himself for it. He usually hated doctors and especially their cold instruments and weird machines which seemed to come straight from a medieval torture chamber._

_The doctor actually chuckled. He couldn't believe it! "You certainly seem to be eager," she remarked then winked at him. "How about I show you your room first and you can get settled in?"_

_Keith nodded. Something in his chest lifted. He wasn't quite sure what it was, but it seemed significant for it made his heart beat faster and tears brick at the inside of his eyes. The last time he had cried was when his mother had died. After that he had sworn he wouldn't cry anymore. He would take every day as it came and live it to the fullest._

_ "Good, let's go then. Oh, and could you do me a favour?" Dr. Howard invaded his personal space and leaned forward so her eyes were directly in front of his. "I'm used to being called Dr. Cat. Dr. Howard makes me feel like some sort of half-god in white and I have been shown my limitation quite often in my line of work. So please could you call me Dr. Cat, too?"_

_Keith swallowed. For a long moment he couldn't find his voice anymore and the urge to cry became more intense. With some difficulties he swallowed the lump in his throat and rasped out, "Yeah, sure, of course."_

_She beamed at him then. "Good."_

_Without another word she started to walk down the corridor, fully expecting him to follow her, and pointed out a room near the end of it. It had a door painted in bright orange and Keith could already read his name on the little blackboard next to it. Someone had drawn little stars and hearts and suns and butterflies around his name and big, bold letters beneath it spelled out 'Welcome'. _

_ "That is your room. Oh, I see Hope has already made good use of the comment space." Dr. Cat smiled warmly and traced the 'Welcome' with her fingers, her eyes holding an odd emotion that Keith couldn't decipher. Then with an obvious effort she pulled herself together again. "Well, usually the nurses will write down your appointments on here or you can write that you don't wish to be bothered right now."_

_She opened the door and motioned for Keith and Henry to go ahead and enter. However she made no move to enter the room herself. _

_ "This is your domain. Feel free to make yourself right at home." She explained and Keith understood that she wouldn't enter his room until he had invited her in. Wow, that was a first! As she made to leave, Keith could see that she was contemplating something. When she finally made up her mind, she turned back around and smiled a little hesitantly._

_ "One more thing, could you please look in on Hope occasionally? She has the room right next door and she sometimes has nightmares and she is afraid of the dark."_

_ "Sure thing," Keith said without really thinking about it, feeling sorry for the little kid next door._


	2. Chapter 2: New Friend

Chapter 2: New friend

I laugh at the memory a little, but I still feel even now the feeling of inevitable change that I had had back then. His essence had captured me. I hadn't been able to deny it back then and I still can't. Can't deny and can't explain.

At first I had thought that Mr. Zetterstrom had me reacting in such a strong way. He had looked a little like my Tom … and it had been years since I had even acknowledged the presence of a man. Keith had stood right behind his father, partially shielded by him, and I have to admit at first I didn't really notice him. Surreptiously I had observed father and son for a moment before going out to greet them. I began to notice Keith, the 'I-don't-give-a-sh*t-about-your-pity'-look in his eyes and the hunched shoulders. My heart went out to him as to every other child and I sternly told myself to ignore the boy's father and concentrate on the boy and making him feel welcome and as comfortable as possible in the situation.

The moment I had greeted Keith all other thoughts had left me for a few heartbeats. His eyes are a startling clear emerald green … so much like my late husband's. His mouth had lines of stubbornness carved around it, making him appear older than the 16 years his file listed. Tom had always teased me that I got this stubborn expression in my eyes and those same lines around my mouth once I set my mind to something (was it stubbornly pushing my way into Medical School despite being a woman or defying the heart-wrenching diagnosis of his eminent death).

Yes, Keith showed certain characteristics he shared with me.

It was for that reason that I couldn't bring myself to just leave him that night.

_Keith stood in front of the door to his neighbour's room. Dr. Cat had asked him to look in on a little girl throughout the night. It was the first time anybody had ever given him any responsibility … other than taking his medications as prescribed. She had not at all treated him like a sick, closer-to-death-than-to-live person, but as a young man who could be trusted. A fervent wish sprang up in him to not disappoint her. _

_That was surprising. When was the last time he had been interested in how others perceived him? In all honesty Keith had long given up on impressing his father, on proving to him that he was still alive and not yet dead. But Henry had lost his wife already and had used up his strength to pretend. He only counted the days left with his son. _

_Keith squared his shoulders and knocked on the door. Time to make someone see he was alive and still kicking._

_ "Come in."_

_The voice wasn't what Keith had expected. It was not the high voice of a small girl. Cautiously he opened the door and stepped over the threshold. He entered a room where all the walls and the ceiling were painted over and over with stars, planets zodiacal symbols, constellations and the Northern Lights. The furniture was kept in midnight blue and most ornaments in the room had something to do with night and the universe. 'Wow, Dr. Cat wasn't lying when she said we should make yourselves right at home', Keith thought awed._

_A telescope stood by the window and a young girl was peering through it. She straightened up and turned around when she noticed his presence in her room. She was about his own age and about the prettiest girl Keith had ever seen. She had blonde hair which caught the moonlight in the room and painted a halo around her head. Her slender body was silhouetted by the light as well, making her nightgown seem almost translucent. Her face and eyes lay in shadows so he couldn't make out her expression, but her voice had sounded musical and friendly._

_ "Yes?" she inquired softly, since he still hadn't spoken a word to her._

_Keith swallowed convulsively and gathered his wayward thoughts. "Hem, yeah, hi," he stammered, quite unintelligible. "I'm K-Keith … the boy next door." He blushed at his words and looked down._

_A rich sound of merriment had him look up again and into blue eyes as Hope had stepped closer to him and smiled gently, offering her hand. "I'm Hope … your girl next door." Was she teasing him? He was incredulous. Then he caught the spark in her eyes. Yes, she most definitely was. "Nice to meet you, Keith. It's nice not to be the oldest kid on the block anymore." This dazzling smile of hers had not left her eyes and her friendliness was sincere. _

_ "Dr. Cat asked me to look in on you … but if you mind … and I totally understand if you do …" Again this sudden caring for others since the new Doctor had come into his life. He stammered and his heart hammered in his chest. "… I won't bother you," he ended lamely. How he hated the awkwardness!_

_Hope flushed a brilliant shade of red now and Keith felt compassion rise in him. He wasn't the only one feeling awkward. _

"_I get nightmares at night and it makes my heart skip and flutter, but I can't sleep with the EKG and the heart monitor attached to my chest … I get the feeling of suffocating then and won't come to rest. Thank you for doing this."_

"_No problem," Keith assured her and he loved the feeling of being the strong one here. _


	3. Chapter 3: Long Forgotten Feelings

Chapter 3: Long Forgotten Feelings

This first meeting of Keith and Hope went very well. In fact they became friends at first sight.

The next morning I saw Keith again … and I couldn't quite believe the change in him. Before any treatment – heck, before any diagnosis had been made, his attitude had already changed. He didn't want to hide anymore. I can imagine that he hadn't been treated like his very own person in a long time; he hadn't seen himself as his own person.

That morning he had almost been strutting towards me.

oOoOoOo

_"Hey, Doc Cat!" he called the moment Catherine stepped out of her office into the corridor._

_Catherine had to smile seeing her newest patient. Right from the beginning she had picked up his strength of character and fighting spirit. She was happy to see a new sense of purpose in him this morning. His shoulders were squared, his chin held high and his eyes met her dead on. Here was a confident young man coming towards her, instead of the sulking teen she had welcomed yesterday. Today she also noticed a merry twinkle in his eyes and a grin on his face. When he stood in front of her, he mock-saluted her, grinning even broader. _

"_Private Zetterstrom reports happily: no incidences during the night. The target person slept soundly. Mission accomplished."_

_Catherine couldn't help herself and began laughing whole-heartedly. She wasn't even sure when she had laughed the last time, or when she had last allowed herself to relax. It seemed a lifetime ago and had probably been before the horrible diagnosis of prostate cancer. Keith somehow made her relax, somehow reminded her that life wasn't over yet._

_She squared her shoulders and looked him straight in the eye. Then she mustered the strictest tone of voice – usually reserved for the most obstinate patients – and barked out, "Soldier, aaat ease!"_

_Keith was a bit thrown; he hadn't expected that but complied happily, widening his stance to shoulder width. Dr. Cat then softened her tone and smiled lovelier than anyone else he could remember. _

_ "Well done, Private Zetterstrom. I'm proud of you."_

_Keith felt a bubble of unadulterated happiness swell in his chest and could have sworn his feet left the floor, floating a good 10 inches above it. He silently chided himself that it had probably meant nothing, had simply slipped from her lips and it was merely another tool to put her patients at ease. Alas it had been too long since he had heard those words and he couldn't stop the deep gratitude he felt or the admiration for Catherine Howard._

_Catherine wasn't quite sure where the words had come from. Tom had always said them to her when she had had a small success. She had longed to say them to their children when they learned something new or excelled at school. Why was she saying it now to this boy she had only met yesterday? It was inconceivable. And yet she had whole-heartedly meant those words. Her eyes went soft when she looked at him and somehow he had intrigued her from the very start. With a sinking feeling she remembered why he was in her ward. He was her patient, ergo needed her help and she had learned quite some years ago that it was a bad idea to get too emotionally attached to the children in her care. She hadn't been able to help it. Always suffering along with her young charges. In her mind she was a sort of surrogate mother for the time these children spent in the hospital. Many came to her crying – out of fear, pain, homesickness, or plain missing their parents – and she had always held them close to her bosom, offering what comfort she could give to these brave little soldiers. Keith was no different. He, too, was fighting a battle against heart-failure and cancer. It seemed inevitable that she would lose him … like she had lost Tom. _

_Better close her heart off before getting hurt. She reversed her easy-going manner and returned to her professional self. "Mr. Zetterstrom, good morning. And how are you today?" she asked him, smiling kindly and stopping on her way to her first patient._

_For a moment Keith wondered again who she was talking to, but then he remembered that it was her way of making him feel welcome and important. "I'm fine, Dr. Cat, thanks. How are you?"_

_Now it was Catherine's turn to be surprised by the forward question. Most people on this ward thought of her as a higher being, a half-god in white as it were. Her patients usually didn't give much thought, if any, to her well-being. Keith was yet again different from the rest and caught her off-guard. _

_She cleared her throat a little and actually had to think about his question. How did she feel? She was always answering the question with "I'm fine" when asked by her friends or colleagues. But was this the truth? She shook her head slightly – but Keith picked it up._

_ "Are you alright, Dr. Cat?" _

_She met his eyes – and couldn't lie. His eyes were too much like Tom's._

"_I suppose you could say, I carry on," she answered honestly. "I'm lonely and I miss my husband, but I try not to think about it too much, submerging myself into work." Her blue orbs filled with tears. Something that hadn't happened in a long time._

_Keith nodded. "I can understand that. I miss my mother, too."_

And with that simple statement we found a common ground and understanding, slowly forming a friendship.


	4. Chapter 4: Setting a Routine

Chapter 4: Setting a Routine

In hindsight I know that I never had a chance to stay 'professionally distant' to Keith. He had grabbed me and holds me in his ban to this day. Before I even examined him, I knew that he wouldn't die of his heart condition … I had read about his diagnosis with cancer, though. He wouldn't die on my watch, but I had no illusions that he would die. When Tom had been diagnosed with prostate cancer, I had fought, tooth and nail, and had denied the inevitable. I had yelled at Tom for being so goddamn calm and accepting of his impending death – now I regret my rash words and wish I could take them back. He had understood, though, taking me into his arms and holding me while I sobbed my heart out. Never before had the age difference between us been more obvious. While I refused to even think about death, let alone his death, Tom had quietly stated that he had had a wonderful, blessed life and no real regrets.

Now I can admit what of Keith reminded me most of Tom. It was his goddamn acceptance, his assumed fearlessness of death. He had admitted as much to me during his treatment.

"I can't change it, so why make it harder for me?" he had stated with the same irritating calm as had Tom.

oOoOoOo

_"Good morning, Keith," Catherine greeted her newest patient with a smile. Today would be his first day of treatment – well, more detailed diagnosis and then the appropriate treatment for it. "Have you settled in?"_

_ "Oh yeah, Dr. Cat," Keith said, grinning and nodding. "Hope has been a great help, showing me all the ropes and giving me the grand tour." He stopped himself, then admitted quietly, "She's really nice."_

_Catherine smiled. It would be like pulling teeth to get Keith to admit more – typical teenager. Keith and Hope, with their 16 years each, were the two oldest residents of the paediatric cardiology ward. Catherine had known that Hope would open up more to someone her own age than to her or a nurse. As for Keith, it was quite plain to see that he longed to take on responsibilities. Hope was one such responsibility. It did him good - she could already see that._

_ "Well, I'm glad you have made a friend. This room you haven't seen yet – and hopefully you won't be here often. It is my main examination room. As you can see, we have a ECG machine and ultra sound devise in here. Both are instruments that allow us to see and hear your heart, giving us a clearer picture of what is amiss and how we proceed from here on out," Catherine explained patiently. It was a speech she had given innumerable times. She had learned early on that most parents didn't really explain what was happening or what was wrong to their children. They were scared by all the strange, cold instruments and only knew that they hurt and that Mummy cried a lot because of them. Catherine had broken the circle on her first work day. Painstakingly she had built a less intimidating and exceedingly friendlier atmosphere. Explaining what she would do, why and how it would work, helped to build trust and she felt her young patients relax – it wouldn't hurt them after all and wasn't scary._

_Keith nodded attentively. His father was usually the one who talked to the doctors, Keith getting shoved into the background. It was the first time he sat in a doctor's office alone, without his dad or social worker. Keith had thought he would be nervous, but he wasn't. Dr. Cat was reassuring and kind. Keith knew he was in good hands, having a doctor who would do everything in her power to make him feel better._

_ "For today, I think, we will start with a ECG test. Well, two of them really," Catherine went on, still smiling reassuringly._

_Keith frowned. "Why two of 'em? Isn't one enough?" he wanted to know._

_Catherine chuckled softly, shaking her head. "As a matter of fact, it wouldn't be enough. We do one when you are relaxed, say reclining on a bed, and we do the other while you're riding a bicycle or jogging. That's called a stress- ECG."_

_ "See, Doc, and that's where we have a problem," Keith said. "Due to my cancer I'm fair weak and get tired very fast. At school I'm not allowed to do sports."_

_ "You must be joking," Catherine interrupted, clearly confused and appalled in equal measures. "I mean, how are you expected to build strength and stamina?" Her forehead was creased into a frown, instead of the usual alabaster plain. Catherine seemed genuinely worried for Keith. "Does not matter," she said imperiously, "we will simply have to change that. Sport is vital for heart patients. It regulates the blood circulation and heartbeat." Her voice had adapted an almost schoolmasterly tone and for the first time she looked strict and somewhat foreboding._

_ "Aye, aye captain!" Keith just couldn't help himself as he mock-saluted her. He had to grin, though, because she reminded him of a mother hen. "So when do we start?" Now that he knew what awaited him he was eager to get started. The sooner he knew what was wrong with his heart, the sooner he could get treatment, and the sooner he could return to school. He would miss Hope and Dr. Cat, though …_

'_Now where had that thought come from?' he asked himself silently, eyes widening slightly. _

_ "Now is as perfect a time as any, wouldn't you agree?" Catherine asked him mockingly, not noticing his averted eyes and the very faint rose hue in his cheeks. _

_oOoOoOo_

_After the ECG tests, which proved that Keith really was in miserable physical shape, Catherine sat in her office and went over the results. They were as she had expected. Nodding to herself, she scanned the sheaves of paper with a graphic of his heart rate and all irregularities from the ECG test. Judging by these results only, she was certain that his heart had been corrupted by the chemotherapy. _

_Slowly she got up from her desk and took the few steps necessary to reach her bookshelf with its vast collection of medical journals, books and charts. With sure hands she took out one book and leafed through it, finding the article almost immediately. _

Cardiotoxicity: A side effect on the heart from chemotherapy is called cardiotoxicity. The term cardiotoxicity refers to general heart damage, and can cause early or late heart damage. Early damage can occur immediately, or within one to two days after the chemotherapy medication is given. Late damage typically begins about one year later, and can appear up to two or three years after chemotherapy. When cardiotoxicity is severe, it could cause congestive heart failure. Cardiotoxicity is the occurrence of heart electrophysiology dysfunction or/and muscle damage. The heart becomes weaker and is not as efficient in pumping and therefore circulating blood. Cardiotoxicity may be caused by chemotherapy treatment. (Wikipedia and another medical site)

_Catherine hoped that tomorrows ultra sound would only show a weakened heart muscle. It would be much worse if it was indeed a electrophysiological dysfunction. Due to Keith's cancer and his chemotherapy an operation to insert a pace maker was almost impossible. The chemotherapy had destroyed his immune system and a small infection of the incision would be fatal. As it were, they already had to take extra precautions against all manner of infections, isolating him from patients with a touch of the flu for instance. Catherine sighed and rubbed the bridge of her nose. There was only speculation and worry left for her tonight. She should go home and sleep. Tomorrow would give her something real to work with._

oOoOoOo

I hadn't found sleep that night. Keith's father, Henry, had called me just in time to stop me on my way out. He had just gotten a new job and had been held up at work, trusting me to take care of his son properly and actually trusting his son to be old enough to handle the diagnostic process. Henry had known that we would do a thorough check-up before beginning any treatment. I told him about the results of the first ECG tests and my preliminary diagnosis. He seemed relieved to hear that and wanted to know how that would affect Keith's chemotherapy. I told him that I couldn't be sure yet and had to wait for the results of the ultra sound test the next day. Henry assured me that he would be there no matter what.

After the call I went home to my solitary dinner and an empty house. As a doctor I'm used to calls at all hours of the night, so it didn't come as a surprise when I got a call at 6 am in the morning. The surprise was that the Police was on the other end of the line. There had been an accident.


End file.
